COPD/Oxygen?

my Dad has severe COPD, after a spell on oxygen in hospital he now has it installed at home. He is prescibed to be on level 2 for 16 hours a day, but he is on level 4 for 24 hours per day, despite our plea's he won't adhere to what he was prescribed. He had a nasty experience when he was rushed into hospital because he couldn't breath, and is now having panic attacks about coming of it, saying he will die. I have spoken to the company that supply the oxygen and they say if he doesn't turn it down they will take it of him.

I am really struggling to know what to do for the best - he is very ill as he has cancer as well and now this mental block with the oxygen.

he has been visited by Doctors, nurses, etc who explain all this to him, but as soon as they have gone, he turns the oxygen back up.......

any advise from anyone who has had a simular situation would be very helpful.

thank you for the answers, its such a delicate situation, we are not sure which was to turn, he is very anxious that his oxygen is not turned down or taken away (and off course we don't want him to be anxious) but the Oxygen company are saying that if he does not turn it down they will take it away - its a no win situation. The Nurse is with him this afternoon, hopefully she can get him to realise the harm he is doing.

I appreciate all your kind answers

oh, lulu, so sorry it has to b ur dad.I remember my grandpa sitting on the sofa, hooked up the that oxygen machine, he'd also sneak off to the camp for a smoke. His reasoning is if they couldn't send him out of the hospital well, then it won't do any good to go back and feel the same way. So he pretty much did what he had to do at home to feel better. he had emphasema for 15 years and lived longer than the doctors predicted by being happy.
At his age, he has no respect for the doctors, and I don't blame him, he's a man and that alone makes him stubborn in regards to doctors and their mumbo-jombo. Just let him have his oxygen, its the only thing right now keeping him happy and alive. Just make sure he knows how brilliant the doctors are and all of the medicial advancements the community itself has made in the last 30 years. He'll need to be taught again how helpful they really can be.

It sounds like he is now dependant on the level 4/24 hours a day. As he is very ill, there is little point in trying to reduce the level back down, as it will just make him more anxious.
He will probably be making the COPD worse, and will no doubt have to be readmitted into hospital due to the level of oxygen he is having, but in all honesty, if he is as ill as you say, then its probably worth just letting him be comfortable and not stressing him out any further.
You could talk to the nurses about it, and explain how anxious he gets, and I'm sure they will agree that in his state, its better for him to be relaxed (as he is less likely to get acutely short of breath).

So sorry to hear of your sad situation. I too have COPD but not as bad as your dad though. I have 3 different inhalers. I was rushed to hospital in January, but a couple of days treatment got me over it.. The oxygen machine is a big help and dad probably feels his breathing is easier with a high setting. He may also have given up knowing he will never be any better and there is nothing to look forward to so why worry what other people say.Probably only a good psychologist could make him see things any differently. You can only persevere and help him as much as you can for the time he has left.

It's all to do with breathing. Healthy people breathe in reaction to the amount of carbon dioxide in their lungs.

People with COPD don't, they go into something called hypoxic drive and they breathe in reaction to oxygen, not carbon dioxide. However, they cannot have too much oxygen or else it will stop the respiratory (breathing) reflex.

This page says a little more about it, but I've picked out the main points: http://student.bmj.com/back_issues/0401/...

Hypoxic Respiratory Drive

There is a group of patients, who represent a small subset of those with chronic lung disease. As a result of long standing lung damage, their alveolar ventilation is inadequate and they tolerate grossly abnormal arterial blood gases. The central chemoreceptors become tolerant of a high partial pressure of carbon dioxide and the kidneys compensate for the respiratory acidosis by retaining bicarbonate (HCO 3 ) so the arterial pH is about normal. These patients rely on hypoxia to make them breath (hypoxic respiratory drive). If such a patient is given too much oxygen respiratory drive will be lost. He or she will not breathe adequately, and the partial pressure of carbon dioxide in arterial blood may rise to dangerous levels causing progressive loss of consciousness and eventually apnoea. Once the patient stops breathing, hypoxia returns but it is not adequate to overcome the depressive effects of the high CO 2 levels, and unless the patient is artificially ventilated he or she may die.
If you think the patient has hypoxic drive he or she may still benefit from oxygen treatment, but it must be given in a controlled manner.


I know that's a little complicated, but basically what it's saying is that they do need SOME oxygen to help them breathe, but too much will actually stop them breathing altogether and is very dangerous. This is why they've told your Dad to have the oxygen on, but only on low - it will be enough to help him breathe, but not so much as to be a danger and stop him breathing altogether.

It sound as though your dad is very ill, I'm sorry to say.
If he feels he needs 4lph i would let him have it. He need to be made as comfortable as possible. Ask his doctor if he can have it and explain the situation. Your dad is the one who suffers with this sad condition and only he knows what makes him feel more comfortable .

Hope this helps best wishes to you and your family xx

OXYGEN IS A DRUG. He has a prescription for 2 l/m and he is using 4 l/m? He needs to turn it down. All drugs have side effects. In patients with COPD, too much oxygen for long periods of time can create a side effect called oxygen induced hypo-ventilation. In other words, too much oxygen can cause him to stop breathing. If he stops breathing, then you know what could happen.

Doctors prescribe medications for a reason. Overdosing on anything is bad. The result of too much oxygen is no different.

Other side effects of oxygen are oxygen toxicity (like a chemical burn of lungs), Absorption atalectises (air sacs collapse because of lack of nitrogen. Also called nitrogen wash out). These could happen too.

The best therapy for COPD patients is pulmonary rehabilitation. PR can help the COPD patient learn to breathe more efficiently. They will teach them how to use their medications correctly and when to use them. They will teach all about the disease process and what he should expect.

I hope this helps.

No advise i'm afraid - just sending positive thoughts your way. I sincerely hope that things improve.
Hugs
XXX

Tell your dad i no what he is going though, my brother died of lung cancer at 18. my dad died from a massive heart attack, my mum has copd and has 2 go in for a triple heart bypass. I no that his condition is bad everyone needs to make sure he needs every bit of help he can get.. how old is your father , i myself have emphasema, my lung collapsed 3 times im 32 i have 4 small kids and i tell u its so hard copd and broncitis is emphasema